Background: The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) raised concerns about the risks of COVID-19 in those with neuroimmunological disorders that affect the central nervous system. Risk factors associated with worse COVID-19 outcomes in multiple sclerosis include increased hospitalizations with B-cell depleting therapies, recent treatment with glucocorticoid use, and Black or African American race. However, little data has been reported on how COVID-19 impacts people with neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD).
Objectives: To describe the impact of COVID-19 on people with NMOSD and MOGAD in North America.
Methods: The COVID-19 Infections in MS and Related Diseases (COViMS) Registry collected data on North American patients with MS and related diseases with laboratory positive or highly suspected SARS-CoV-2 infection. De-identified data were entered into a web-based registry by health care providers. Data were analyzed using t-tests, Pearson’s chi-square or Fisher’s Exact tests for categorical variables. Univariate logistic regression models examined effects of risk factors and COVID-19 clinical severity.
Results: As of April 1, 2021, 66 NMOSD and 15 MOGAD patients were reported in the COViMS Registry. Most NMOSD patients were laboratory positive for SARS-CoV-2 and taking rituximab at time of COVID-19 diagnosis. Most NMOSD patients were not hospitalized (66.7% [95%CI:54.0-77.8%]), while 12.1% (95%CI:5.4-22.5%) were hospitalized only, 9.1% (95%CI:3.4-18.7%) were admitted to the ICU and/or ventilated, and 12.1% (95%CI:5.4-22.5%) died. In NMOSD patients, having a comorbidity was the sole factor identified for poorer COVID-19 outcome (OR=6.3, 95%CI:1.64-24.52). Most MOGAD patients were laboratory positive for SARS-CoV-2 and almost half were taking rituximab. Among MOGAD patients, 73.3% were not hospitalized and no deaths were recorded; no factors were different between those not hospitalized versus those hospitalized, admitted to the ICU, or ventilated.
Conclusions: Among the reported NMOSD patients, a high mortality rate was observed and presence of comorbid conditions were associated with worse COVID-19 outcome. MOGAD patients appear to fare better than NMOSD patients, with fewer reported with severe COVID-19 outcome and no reported deaths.